Friday, March 05, 2021

January 24, 2021 Straining to handle record numbers of COVID-19 patients, hundreds of the nation’s intensive care units are running out of space and supplies and competing to hire temporary traveling nurses at soaring rates. Many of the facilities are clustered in the South and West. An Associated Press analysis of federal hospital data shows that since November, the share of U.S. hospitals nearing the breaking point has doubled. More than 40% of Americans now live in areas running out of ICU space, with only 15% of beds still available.

Intensive care units are the final defense for the sickest of the sick, patients who are nearly suffocating or facing organ failure. Nurses who work in the most stressed ICUs, changing IV bags and monitoring patients on breathing machines, are exhausted.

“You can’t push great people forever. Right? I mean, it just isn’t possible,” said Houston Methodist CEO Dr. Marc Boom, who is among many hospital leaders hoping that the numbers of critically ill COVID-19 patients have begun to plateau. Worryingly, there’s an average of 20,000 new cases a day in Texas, which has the third-highest death count in the country and more than 13,000 people hospitalized with COVID-19-related symptoms.

According to data through Thursday from the COVID Tracking Project, hospitalizations are still high in the West and the South, with over 80,000 current COVID-19 hospital patients in those regions. The number of cases reported in the U.S. since the pandemic’s start surpassed 25 million on Sunday, according to Johns Hopkins University.

Encouragingly, hospitalizations appear to have either plateaued or are trending downward across all regions. It’s unclear whether the easing will continue with more contagious versions of the virus arising and snags in the rollout of vaccines.

In New Mexico, one surging hospital system brought in 300 temporary nurses from outside the state, at a cost of millions of dollars, to deal with overflowing ICU patients, who were treated in converted procedure rooms and surgery suites.

“It’s been horrid,” said Dr. Jason Mitchell, chief medical officer for Presbyterian Healthcare Services in Albuquerque. He’s comforted that the hospital never activated its plan for rationing life-saving care, which would have required a triage team to rank patients with numerical scores based on who was least likely to survive.

“It’s a relief that we never had to actually do it,” Mitchell said. “It sounds scary because it is scary.”

In Los Angeles, Cedars-Sinai Medical Center ran into shortages of take-home oxygen tanks, which meant some patients who could otherwise go home were kept longer, taking up needed beds. But the biggest problem is competing with other hospitals for traveling nurses.

“Initially, when the COVID surges were hitting one part of the country at a time, traveling nurses were able to go to areas more severely affected. Now with almost the entire country surging at the same time,” hospitals are paying twice and three times what they would normally pay for temporary, traveling nurses, said Dr. Jeff Smith, the hospital’s chief operating officer.

Houston Methodist Hospital recently paid $8,000 retention bonuses to keep staff nurses from signing up with agencies that would send them to other hot spots. Pay for traveling nurses can reach $6,000 per week, an enticement that can benefit a nurse but can seem like poaching to the hospital executives who watch nurses leave.

“There’s a lot of these agencies that are out there charging absolutely ridiculous sums of money to get ICU nurses in,” Boom said. “They go to California, which is in the midst of a surge, but they poach some ICU nurses there, send them to Texas, where they charge inordinate amounts to fill in gaps in Texas, many of which are created because nurses in Texas went to Florida or back to California.”

Space is another problem. Augusta University Medical Center in Augusta, Georgia, is treating adult ICU patients, under age 30, in the children’s hospital. Recovery rooms now have ICU patients, and, if things get worse, other areas — operating rooms and endoscopy centers — will be the next areas converted for critical care.

To prevent rural hospitals from sending more patients to Augusta, the hospital is using telemedicine to help manage those patients for as long as possible in their local hospitals.

“It is a model I believe will not only survive the pandemic but will flourish post-pandemic,” said Dr. Phillip Coule, the Augusta hospital’s chief medical officer.

Hospitals are pleading with their communities to wear masks and limit gatherings.

“There just hasn’t been a lot of respect for the illness, which is disappointing,” said Dr. William Smith, chief medical officer for Cullman Regional Medical Center in Cullman, Alabama. He sees that changing now with more people personally knowing someone who has died.

“It has taken a lot of people,” he said of the virus, adding that the death toll — 144 people in six months in a county of 84,000 — “has opened their eyes to the randomness of this.”

The Alabama hospital’s ICU has been overflowing for six weeks, with 16 virus patients on ventilators in a hospital that a year ago had only 10 of the breathing machines. “You can see the stress in people’s faces and in their body language. It’s just a lot for people to carry around,” Smith said.

“Just the fatigue of our staff can affect the quality of care. I’ve been encouraged we’ve been able to keep the quality of care high,” Smith said. “You feel like you are in a very precarious situation where errors could occur, but thankfully we’ve managed to stay on top of things.”

Hospitals say they are upholding high standards for patient care, but experts say surges compromise many normal medical practices. Overwhelmed hospitals might be forced to mobilize makeshift ICUs and staff them with personnel without any experience in critical care. They might run out of sedatives, antibiotics, IVs or other supplies they rely on to keep patients calm and comfortable while on ventilators.

“It’s really daunting and mentally taxing. You’re doing what you believe to be best practice,” said Kiersten Henry, a nurse at MedStar Montgomery Medical Center in Olney, Maryland, and a board director for the American Association of Critical-Care Nurses.

In Oklahoma City, OU Medicine Chief Medical Officer Dr. Cameron Mantor said while the vaccines hold promise, hope still seems dim as ICU cases keep mounting. The number of COVID-19 hospitalizations at OU Medicine has declined from more than 100 daily in recent weeks to 98 on Wednesday, Mantor said.

“What is stressing everybody out,” Mantor said, “is looking at week after week after week, the spigot is not being turned off, not knowing there is a break, not seeing the proverbial light at the end of the tunnel.”

Entertainment

February 28, 2021    NEW YORK (AP) — When drained of glamour, what’s left of the Golden Globes? That’s one of the biggest questions heading into the 78th annual awards on Sunday night. The show, postponed two months from its usual early-January perch, will have little of what makes the Globes one of the frothiest and glitziest events of the year. Due to the pandemic, there will be no parade of stars down the red carpet outside the Beverly Hilton in Beverly Hills, California. Its hosts, Tina Fey and Amy Poehler will be on different sides of the country.

February 26, 2021  NEW YORK (AP) — Most playwrights who dip their toes into musical theater for the first time go small. Not Katori Hall: Her first assignment was to capture the life of a musical giant — Tina Turner. “I’m not really scared of much, which is probably why I felt like ‘Oh yeah, I’ll try this. I’ll take Tina Turner, one of the biggest icons in the world, and attempt to retell her story in this musical form,’” Hall says, laughing. “I had no qualms whatsoever.” That fearlessness has led to Hall’s first Tony nominations, as a producer and book writer for “Tina — The Tina Turner Musical.” At the awards show, it will compete against “Jagged Little Pill” and “Moulin Rouge! The Musical!” for Broadway’s best new musical crown.

February 26, 2021   NEW YORK (AP) — Netflix on Friday released a study it commissioned from top academic researchers that shows the streaming giant is outpacing much of the film industry in the inclusivity of its original films and television series. For years, academic studies have sought to capture inequalities in Hollywood and to hold studios accountable for making film and television that doesn’t reflect American demographics. Those studies have generally relied on box-office or ratings data, often leaving out streaming platforms. Netflix is trying a different route with both more transparency and more company control. The streamer commissioned the USC Annenberg Inclusion Initiative to analyze its 2018 and 2019 original, live-action films and series, and presented the results to members of the press Thursday in a video presentation. The results were, as Annenberg Inclusion Initiative founder and director Stacy L. Smith noted, far more positive than most Annenberg reports, which have typically found only slow, sporadic improvement in the most popular films.

 

February 26, 2021  NEW YORK (AP) — Four hours of morning television is a lot of time to fill, but new Black News Channel hosts Mike Hill and Sharon Reed don’t expect to run out of things to say. Their new program, which debuts Monday at 6 a.m. Eastern, is the centerpiece of Black News Channel’s relaunch to emphasize commentary and a more analytical approach to the news. Nearly invisible when it debuted last year, BNC is methodically becoming more available to viewers. “This is when I need my voice to be heard and I want my voice to be heard,” said Hill, who has worked at Fox Sports and ESPN. “So much is happening in our country.”

Business News

 

February 28, 2021  WASHINGTON (AP) — The U.S. is getting a third vaccine to prevent COVID-19, as the Food and Drug Administration on Saturday cleared a Johnson & Johnson shot that works with just one dose instead of two. Health experts are anxiously awaiting a one-and-done option to help speed vaccinations, as they race against a virus that already has killed more than 510,000 people in the U.S. and is mutating in increasingly worrisome ways. The FDA said J&J’s vaccine offers strong protection against what matters most: serious illness, hospitalizations and death. One dose was 85% protective against the most severe COVID-19 illness, in a massive study that spanned three continents — protection that remained strong even in countries such as South Africa, where the variants of most concern are spreading.

February 28, 2021  WASHINGTON (AP) — Looking beyond the $1.9 trillion COVID relief bill, President Joe Biden and lawmakers are laying the groundwork for another top legislative priority — a long-sought boost to the nation’s roads, bridges and other infrastructure that could run into Republican resistance to a hefty price tag. Biden and his team have begun discussions on the possible outlines of an infrastructure package with members of Congress, particularly mindful that Texas’ recent struggles with power outages and water shortages after a brutal winter storm present an opportunity for agreement on sustained spending on infrastructure.

February 26, 2021    WASHINGTON (AP) — On a cold, gray February afternoon, Treasury Secretary Janet Yellen stepped out of the West Wing wrapped in a puffy black parka and clutching a folder of documents, seemingly oblivious to the Washington custom of having an aide schlep the paperwork. Viewed as an outsider to partisan politics, she now has a place in President Joe Biden’s inner sanctum, a Ph.D. economist who does the reading, knows the numbers and treats her staff as peers rather than underlings. Yellen, entourage in tow, had been at the White House to strategize about how to push through Biden’s proposed $1.9 trillion coronavirus relief plan -- a package that could determine how quickly the U.S. economy heals, how the Democrats fare in the midterm elections and just how much Americans can trust the government to solve the nation’s toughest problems.

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